Patel Jeet Janak, Carbajal-Tamez Marcela, Baumgartner William, Abraham Cristina, Leung Edison, Quevedo João
Center for Interventional Psychiatry, Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.
Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.
Front Psychiatry. 2025 Aug 15;16:1563519. doi: 10.3389/fpsyt.2025.1563519. eCollection 2025.
We present a case of a 35-year-old patient with treatment-resistant depression and an implanted sacral neurostimulator for overactive bladder (OAB). The patient experienced an exacerbation of depression with suicidal ideation and failed multiple medication trials. Due to her significant history of adverse medication reactions and the severity of her condition, electroconvulsive therapy (ECT) was selected as a treatment option despite concerns about the safety of administering ECT with a sacral neurostimulator. To minimize potential risks, the device was placed in Magnetic Resonance Imaging (MRI) mode during each ECT session, successfully avoiding electrical interference. She underwent three ECT sessions, which resulted in significant improvement in depressive symptoms and resolution of suicidal ideation without adverse effects on the device's integrity or OAB symptoms. This case highlights the feasibility and safety of ECT in patients with implanted sacral neurostimulators, emphasizing the importance of precautionary measures and individualized patient assessment. Further research is needed to explore the long-term effects of ECT on such devices and their impact on OAB.
我们报告一例35岁患有难治性抑郁症且植入骶神经刺激器治疗膀胱过度活动症（OAB）的患者。该患者抑郁症加重并出现自杀意念，多次药物试验均失败。鉴于其有显著的药物不良反应史及病情严重程度，尽管担心使用骶神经刺激器时进行电休克治疗（ECT）的安全性，但仍选择ECT作为治疗方案。为将潜在风险降至最低，每次ECT治疗期间将设备置于磁共振成像（MRI）模式，成功避免了电干扰。她接受了三次ECT治疗，抑郁症状显著改善，自杀意念消除，且未对设备完整性或OAB症状产生不良影响。该病例突出了ECT在植入骶神经刺激器患者中的可行性和安全性，强调了预防措施和个体化患者评估的重要性。需要进一步研究来探索ECT对此类设备的长期影响及其对OAB的作用。
